Splenogonadal fusion (SGF) is a rare cause of testicular mass with the vast majority of cases presenting in men under the age of 30 and represents a diagnostic challenge. Discontinuous splenogonadal fusion presenting as a new testicular mass in a 55-year-old man is discussed to aid other surgeons in diagnosing this condition.

Mentions:
A 55-year-old male presented to the urology clinic with obstructive voiding complaints. Past medical history was significant for cardiac disease, otherwise unremarkable. On physical exam he was found to have a 3 cm firm left sided upper pole testicular mass. On further questioning, he had never noticed this mass nor had any of his providers. Scrotal ultrasound revealed a well-circumscribed, focal, solid intratesticular lesion measuring 2.4 × 2.5 × 2.4 cm suspicious for testicular mass (Fig. 1) Serum AFP, HCG, and LDH were negative. Chest X-ray was negative for metastatic disease. CT of the abdomen and pelvis showed no adenopathy in the retroperitoneum. Given the appearance on ultrasound and the history of new testicular mass, left radical inguinal orchiectomy was performed uneventfully. The pathology report revealed a spermatic cord lipoma, benign testicle and epididymis, and splenogonadal fusion with splenic tissue involving the superior pole, 2.5 cm in maximal diameter. The splenic tissue had a well delineated fibrous encapsulation, separate from the testicular tissue (Figure 2, Figure 3).

Mentions:
A 55-year-old male presented to the urology clinic with obstructive voiding complaints. Past medical history was significant for cardiac disease, otherwise unremarkable. On physical exam he was found to have a 3 cm firm left sided upper pole testicular mass. On further questioning, he had never noticed this mass nor had any of his providers. Scrotal ultrasound revealed a well-circumscribed, focal, solid intratesticular lesion measuring 2.4 × 2.5 × 2.4 cm suspicious for testicular mass (Fig. 1) Serum AFP, HCG, and LDH were negative. Chest X-ray was negative for metastatic disease. CT of the abdomen and pelvis showed no adenopathy in the retroperitoneum. Given the appearance on ultrasound and the history of new testicular mass, left radical inguinal orchiectomy was performed uneventfully. The pathology report revealed a spermatic cord lipoma, benign testicle and epididymis, and splenogonadal fusion with splenic tissue involving the superior pole, 2.5 cm in maximal diameter. The splenic tissue had a well delineated fibrous encapsulation, separate from the testicular tissue (Figure 2, Figure 3).

Splenogonadal fusion (SGF) is a rare cause of testicular mass with the vast majority of cases presenting in men under the age of 30 and represents a diagnostic challenge. Discontinuous splenogonadal fusion presenting as a new testicular mass in a 55-year-old man is discussed to aid other surgeons in diagnosing this condition.